Webinar series and networking event, co-hosted by Migration Mobilities Bristol Institute with the Glasgow Refugee, Asylum and Migration Network (GRAMNet)
Health is a fundamental human right, yet in practice, there are many barriers to the realisation of ‘Health for All’. The health inequalities and barriers to access healthcare systems faced by people-onthemove and by non-citizens more generally, have long been recognised in research, policy and practice. While the World Health Organisation continues to advocate for ‘migrant sensitive health systems’ (2010), healthcare systems are bounded within the nation state, subject to the laws and policies of governments that increasingly restrict the rights of ‘migrants’ to access their rights. As rights to health are restricted, health and social protection systems are mobilised within hostile environment regimes as a means of surveillance.
The COVID-19 pandemic illustrated the need for universal health care and the fragility of national health systems. This series of four webinars and one online networking event is organised by MMB and University of Glasgow’s GRAMNet and will reflect on access to health care for migrants, refugees and those seeking asylum. Starting from different disciplinary standpoints, the speakers offer empirical and theoretical work exploring the relations between health and migration and the role of migration systems in the production of health inequalities. We will end the series with a (fun!) online networking event.
Webinar 2 – Exploring the mental health and psychosocial experiences of asylum seekers, refugees and undocumented migrants in the post migration context
Further information and register here.
With Alessio Albanese and Kate O’Donnell.
Ample research has demonstrated the effects of pre migration experiences (e.g., war, persecution, violence, torture) on the mental health of asylum seekers, refugees and undocumented migrants. More recently, however, research has begun to illustrate the impact of post-migration life difficulties on the psychosocial experiences of these migrant groups. Evidence shows that particular areas of concern for the mental health of these populations include: migration detention, the asylum system, fear of deportation, poverty, destitution, housing issues, language and communication difficulties, and poor access to healthcare.
Three methodological approaches to collect and analyse data were used: a systematic review and meta ethnography, Reflexive Thematic Analysis (RTA) and the theory of Candidacy. The systematic review included the qualitative component of 20 studies (11 qualitative and 9 mixed methods), assessed against pre-established inclusion criteria. These were analysed by applying a meta-ethnographic approach. Subsequently, 18 asylum seekers, refugees and undocumented migrants based in the Glasgow area were interviewed. RTA was employed to analyse the data gathered. The interviews were then re-analysed using the theory of Candidacy to understand in more detail participants’ journeys to accessing the services needed (including healthcare).
Combined, the findings indicate that the asylum system is a social determinant of health for asylum seeker, refugee and undocumented migrant populations in the UK and internationally. For asylum seekers and undocumented migrants, the inability to work and financial insecurity stemming from Home Office restrictions were shown to compound distress. In relation to mental health, psychosomatic symptoms and difficulties with sleep were reported, whilst protective factors included family, friends, religion, and hobbies such as exercise and playing music. Access to care was described as arduous due to language and communication difficulties, limited availability of interpreters, and issues registering with a GP. This was due to the limited information and knowledge available to them. Often this was mitigated by third sector organisations. Access to mental health services was consistently shown to be undermined by the Western biomedical approach, which failed to consider socio-cultural factors that may further limit access (e.g., prescription of psychotropic medication). The secondary analysis of the interviews also showed that proximal as well as broader operating conditions influenced access to services. These comprised of three levels: micro-, meso- and macro. Efforts to improve asylum seekers’, refugees’ and undocumented migrants’ access to services, including healthcare, need to consider the psychosocial and cultural aspects of mental health in these populations. Health services have a responsibility in lessening the structural barriers and inequity in access that these populations face.